Abstract
Purpose :
Previous work has shown the presence of multiple inflammatory molecules (e.g. IL-6, IL-8, IL-17) and VEGF in the aqueous humor in patients with diabetic retinopathy (DR). Literature shows that only a few proteins in both lumens correlate with aqueous humor and vitreous humor. The current study sought to understand the relationship between vitreous molecules and the background stage of inflammation, based on the status of DR, and also retinal anatomy, based on area of retinal thickness (ART).
Methods :
The single center phase IV investigator initiated ILUVIT study was approved by BfARM (EudraCT-Number 2016-004488-38) for the analysis and evaluation of 12 eyes from patients with diabetic macula edema (DME). In the context of this study one partial vitrectomy (pPPV) was performed for diagnostic purposes before implantation of the fluocinolone acetonide (ILUVIEN) implant. The extracted vitreous material was examined for the determination of growth and inflammatory factors (including IL-6, IL-8, IP-10, MCP-1, PIGF, VEGF and CD54). These were linearly compared (using Kendall’s Tau and Spearman’s Rank Correlation Coefficient) with the grade of inflammation in the vitreous, assessed via DR stage, and ART.
Results :
DR was found to linearly correlate with the expression of CD54 (rho=0.64; p=0.03), IL-8 (rho=0.64, p=0.02), and PIGF (rho=0.75, p=0.006). ART correlated also with CD54 (rho=0.62, p=0.03) and a tendency was found with IL-8 (rho=0,55, p=0.06), but not PIGF (rho=0.47, p=0.12).
For VEGF, there was a lack of correlation with ART (rho=0.188, p=0.55) and a trend with DR (rho=0.52, p=0.08). No correlations were found for all other comparisons (p>0.05).
Conclusions :
The current study shows the importance of taking samples from the compartment of the eye which is affected by disease – in this case the vitreous sample from patients with DME. The present data revealed that increased clinical inflammatory stage was related to the expression of CD54, IL-8 and PIGF. These results are exploratory and may be important in defining the effectiveness of patient’s therapy. Especially in an individuum with a resistant DME it could be worth to take vitreous probes to decide which therapy approach (kind of anti-VEGF or steroid) could be the most appropriate treatment for the individual patient’s eye.
This is a 2020 ARVO Annual Meeting abstract.